Individual
RUTH KOKU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
634 WALDEN LANDING DR, HAMPTON, GA 30228-6234
(954) 821-7494
(770) 471-4468
Mailing address
634 WALDEN LANDING DR, HAMPTON, GA 30228-6234
(954) 821-7494
(770) 471-4468
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
196779
GA
163W00000X
Registered Nurse
2597822
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302750300
—
FL
Enumeration date
08/11/2016
Last updated
08/11/2016
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